• Tuberculosis and Respiratory Diseases
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• v.76 no.5
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• pp.199-210
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• 2014

Pleural effusion is not a rare disease in Korea. The diagnosis of pleural effusion is very difficult, even though the patients often complain of typical symptoms indicating of pleural diseases. Pleural effusion is characterized by the pleural cavity filled with transudative or exudative pleural fluids, and it is developed by various etiologies. The presence of pleural effusion can be confirmed by radiological studies including simple chest radiography, ultrasonography, or computed tomography. Identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments. This review article provides information on the diagnostic approaches of pleural effusions and further suggested ways to confirm their various etiologies, by using the most recent journals for references.

• Microbiology and Biotechnology Letters
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• v.27 no.4
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• pp.339-343
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• 1999

Pasteurella haemolytica is well known to cause severe pneumonia, consolidation and oedema of the lung, and fibrinous pleurisy under the stress and infection of virus in the cattle. In the course of our screening for antimicrobial agents against P.haemloytica, compound 51086 has been isolated from the fermentation broth of Streptimyces sp. 51086. The compound 51086 was purified by SiO2, Sephadex LH-20 and ODS column chromatographies and HPLC, subsequently. The structure of compound 51086 was determined as hygromycin A by combination of 1H NMR, 13C NMR, HMBC, and ESI-MS. This compound showed significant antibacterial activity against P.haemolytica and P.multocida.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.49-54
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• 1969

Four cases of pleural mesothelioma were treated surgically. The tumors from all cases were microscopicaly malignant, although only in one case the tumor was found to be diffuse in growth. The diagnosis made before operation were exudative pleurisy, empyema or lung cancer with no tumor cells found in examination of pleural fluid, sputum or the specimen of pleuraI biopsy. In two cases only the tumors were resected, and in other two cases pneumonectomy and pleuropneumonectomy were performed. Irradiations added in two cases postoperatively were found not to be beneficial. Postoperative recurrence of tumor growth were found in three cases within two months after surgery, and in one case no evidence of recurrence was noted four and a half months after resection of the tumor.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1102-1106
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• 1992

A 66-year-old male patient was admitted due to chest pain and dyspnea of 1 year duration, He had history of treatment for tuberculosis and pleurisy, about 40 years ago. At another hospital the patient underwnt closed thoracostomy drainage for six months, and thereafter the symptom gradually aggrevated. Under the diagnosis of chronic tuberculous empyema, decortication was performed. The peel attached to the posterolateral aspect of chest wall, there was an area of soft tissues with pale-brown discoloration, extending to intercostal muscles, but sparing overlying muscles. The biopsy specimen of the lesion was pathologically diagnosed as diffuse, large T-cell non-Hodgkin`s lymphoma. A review of the literature showed that malignant lymphoma of this type have been reported exclusively from Japan but never from other countries including Korea. After 1 year of followup period, the patient is well and stable.

• Korean Journal of Pharmacognosy
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• v.27 no.2
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• pp.146-154
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• 1996

Korean folk medicine 'Jil-Kyung-Ee' has been used to cure female disease, acute gastritis, edema, abdominal pain and pleurisy. The botanical origin of the crude drug has not been confirmed pharmocognostically. To clarify the botanical origin of 'Jil-Kyung-Ee', the morphological and anatomical characteristics of the leaves and roots of Plantago species growing in Korea, i.e. P. asiatica L., P. camtschatica Cham., P. depressa Willd., P. lanceolata L., P. major L. var. japonica (Fr. et Sav.) Miyabe were compared. As a result, it was determined that 'Jil-Kyung-Ee' was the whole plant body of Plantago asiatica and Plantago camtschatica.

• Journal of Veterinary Science
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• v.24 no.5
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• pp.68.1-68.6
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• 2023

Leopard cat (Prionailurus bengalensis euptilurus) is a small wild cat assessed as an endangered wildlife in Korea. There have been very few reports of their diseases. Herein, we describe fibrinous pleuritis caused by Streptococcus canis infection with excessive pleural effusion, hydropericardium, mild ascites, and liver fibrosis in a leopard cat. S. canis is a commensal microflora in domestic cats and often affects the upper respiratory tract inducing chronic and severe respiratory diseases. However, there is no literature regarding the S. canis in leopard cats. Therefore, we first report fibrinous pleuritis associated with an S. canis infection in a leopard cat.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.149-161
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• 2000

Background : Residual pleural thickening (RPT) develops in about 50% of tuberculous pleurisy ($PL_{TB}$). Some reports have suggested that elevated TNF-$\alpha$ and impaired fibrinolysis could be the cause of RPT, but until now, the mechanism and predictors of RPT have not been well known. TGF-$\beta$ has been known to promote fibrogenesis and is increased in tuberculous pleural fluid (PF). $PL_{TB}$ and malignant pleurisy ($PL_{MAL}$) manifest lymphocyte-dominant exudative pleural effusion, and it has clinical implications in the differentiation of the two diseases based on the findings of pleural effusion. We performed this study to compare pleural fluid TNF-$\alpha$ TGF-$\beta$, and fibrinolytic parameters between $PL_{TB}$ and $PL_{MAL}$, and to find the predictors of RPT in $PL_{TB}$. Methods : Thirty-five $PL_{TB}$ and 14 $PL_{MAL}$ patients who were admitted to the Asan Medical Center from February 1997 to August 1999 were enrolled. All $PL_{TB}$ patients were prescribed a primary, short-course, anti-tuberculosis regimen. INF-$\alpha$ tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), plasminogen, $\alpha$2-antiplasmin, and D-dimer were measured in both PF and PB. TGF-$\beta$was measured only in PF. Clinical characteristics, TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters were compared between patients with RPT less than 2 mm and patients with more than 2 mm of the thirty patients who completed the anti-tuberculosis treatment. Results : The levels of TNF-$\alpha$ tPA, PAI-1, plasminogen, $\alpha$2-antiplasmin, and D-dimer in PF were higher than those in peripheral blood (PB) in $PL_{TB}$, whereas only plasminogen, $\alpha$2-antiplasmin, and D-dimer were higher in PF than in PB in $PL_{MAL}$. Pleural fluid TNF-$\alpha$ TGF-$\beta$, PAI-1, plasminogen, $\alpha$2-antiplasmin were increased in $PL_{TB}$ compared with $PL_{MAL}$, but these factors did not show any further advantages over ADA in differentiation between $PL_{TB}$ and $PL_{MAL}$. TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters did not show any differences between patients with RPT less than 2 mm and patients with RPT more than 2 mm. Conclusion : Our data suggest that TNF-$\alpha$, TGF-$\beta$ and fibrinolytic parameters may play some role for the development of RPT in $PL_{TB}$, but they failed to predict the occurrence of RPT in $PL_{TB}$. Also these parameters did not seem to have any advantages over ADA in differentiating between two diseases.

• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.69-76
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• 2005

Background : Residual pleural thickening (RPT) is the most common complication of tuberculous pleurisy (TP), despite adequate anti-tuberculous chemotherapy. At the conclusion of treatment, 43-50% of patients present RPT, with its incidence varying according to the time of evaluation. To assess the spontaneous resolution of RPT, the RPT at the completion of treatment was compared with that at the final follow-up. The factors related to the development of RPT after the completion of treatment were also studied. Methods : The medical records of sixty four patients, diagnosed with TP between March 2001 and June 2003, were retrospectively. The RPT was measured at the completion of treatment and at the time of the final follow-up and the degree and frequency of RPT compared between the two measurements. Each time, the patients were divided into two groups: those with and without RPT. The clinical characteristics and the radiographic and pleural fluid findings of the two groups were compared. Results : Thirty six (56%) and 27 patients had RPT at the completion of treatment and at the time of the final follow-up, respectively (median follow up period: 8 months). Spontaneous resolution of the RPT was found in 9 patients (24%), and had decrease below 10mm in 15 (42%) during the follow-up period after treatment. The patients were initially divided into two groups: 36 and 27 patients with and without RPT, respectively. There was no predicting factor of RPT, with the exception of the presence of CRP, between the two groups. The patients were also separated into two groups at the time of final visit: 27 and 37 patients with and without RPT, respectively. The patients with RPT were found to have a lower total WBC count in pleural fluid. Conclusion : 57% of patients with RPT were found to have spontaneous resolution of the residual pleural thickening after completion of the chemotherapy. The time of evaluation for RPT and its predicting factors were decided after adequate follow-up, irrespective of the completion of treatment.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.437-443
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• 2009

Background: The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB). Methods: We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio. Results: 108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA ($\geq$40 IU/L). When we considered ADA $\geq$40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and posttest posttest probability 74.5%. However, when we considered ADA $\geq$40 IU/L combined with the L/N ratio $\geq$0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans. Conclusion: To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.

• Tuberculosis and Respiratory Diseases
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• v.67 no.4
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• pp.331-337
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• 2009

Background: The whole-blood interferon-gamma release assay (QuantiFERON-TB Gold [QFT-G]: Cellestis, Carnegie, Victoria, Australia) has been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. In the present study, the usefulness of QFT-G was evaluated for the diagnosis of extra-pulmonary tuberculosis (EP-TB). Methods: From June 2006 to February 2009, we evaluated the usefulness of QFT-G in patients (n=65) suspected with EP-TB, retrospectively. The diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the QFT-G assay were analyzed. Results: EP-TB was diagnosed in 33 (51%) participants. The overall sensitivity, specificity, PPV, and NPV of the QFT-G assay for EP-TB were 78%, 79%, 81%, and 77%, respectively. Of the 33 with EP-TB, 14 (42%) were diagnosed with TB pleurisy, 7 (21%) with TB lymphadenitis, 7 (21%) with intestinal TB, and 5 (15%) with EP-TB in other sites. In subgroup analyses according by site of infection, the QFT-G showed 86% sensitivity, 64% specificity, and 78% NPV in TB pleurisy. On the other hand, the sensitivity, specificity, and NPV of the assay were 71%, 83% and 71%, respectively in TB lymphadenitis, and 86%, 100% and 88%, respectively in intestinal TB. Among the patients with suspected alternative site EP-TB, the sensitivity, specificity, and NPV of the assay were 50%, 80% and 67%, respectively. Conclusion: The QFT-G assay showed moderate diagnostic accuracy in EP-TB. However, negative QFT-G assay does not exclude EP-TB because of the low NPV of this assay.